Question 1

A patient with HIV contracts herpes simplex virus (HSV), and the prescriber orders acyclovir 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. What action will the provider take?

Accepted Answer

In cases where HSV lesions increase or do not improve with initial acyclovir therapy, especially in immunocompromised patients like those with HIV, resistance to acyclovir may be suspected. Foscarnet is an alternative antiviral medication used for treating acyclovir-resistant HSV infections.

Question 2

A provider determines that a patient requires a prescription for a narrow spectrum antibacterial drug to treat a gram-positive cocci-related infection. What option will the provider consider? (Select all that apply.)

Accepted Answer

Erythromycin, Penicillin G, and Vancomycin are all narrow-spectrum antibacterial drugs that are effective against gram-positive cocci.

Question 3

A female patient who has hepatitis C is being treated with pegylated interferon$\alpha$ and ribavirin. It will be important for the provider to discuss what topic with the patient?

Accepted Answer

Ribavirin is teratogenic, and it is crucial to avoid pregnancy during treatment. Monthly pregnancy tests are necessary to ensure the patient is not pregnant while on this medication.

Question 4

A young female patient is seen in a rural clinic after complaining of abdominal pain. The patient is wearing dirty clothing and is barefoot. The provider orders a complete blood count, which shows that the patient is anemic. The provider suspects that this patient has which of the following infestations?

Accepted Answer

Ancylostomiasis (hookworm) is often contracted through direct contact with contaminated soil, typically when barefoot. The patient's presentation of anemia and the environmental clues (dirty clothing and barefoot) support this diagnosis. Hookworms cause blood loss leading to anemia.

Question 5

A patient diagnosed with HIV and mucocutaneous HSV is being treated with foscarnet after failing treatment with acyclovir. After 2 weeks, the patient's dose is increased to 90 mg/kg over 2 hours from 40 mg/kg over 1 hour. The patient reports numbness in the extremities and perioral tingling. What action will the provider take?

Accepted Answer

Foscarnet can cause electrolyte imbalances, including hypocalcemia, which can lead to symptoms like numbness and tingling. Checking the serum calcium level is appropriate.

Question 6

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The provider will order which drug?

Accepted Answer

Azithromycin is the preferred treatment for Chlamydia trachomatis infection in pregnant women due to its safety profile and effectiveness. Doxycycline is contraindicated in pregnancy, and erythromycin ethylsuccinate is an alternative but less preferred option. Sulfisoxazole is not used for treating chlamydial infections.

Question 7

A patient is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies, including didanosine. Which laboratory findings would most concern the provider?

Accepted Answer

Increased serum amylase and triglycerides and decreased serum calcium are concerning because they can indicate pancreatitis and dyslipidemia, which are known side effects of didanosine.

Question 8

A patient starting therapy with efavirenz asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the prescriber provide?

Accepted Answer

Efavirenz is best taken on an empty stomach, preferably at bedtime, to reduce side effects such as CNS symptoms. Taking it with food, especially a high-fat meal, can increase the drug's concentration and the risk of side effects.

Question 9

A patient is diagnosed with pelvic inflammatory disease (PID). Which treatment regimen is most appropriate for reducing the risk of sterility in this patient?

Accepted Answer

Hospitalization with IV antibiotics like doxycycline and cefoxitin is recommended for severe cases of PID to effectively reduce the risk of complications such as sterility.

Question 10

A patient with a history of congestive heart failure and renal impairment is diagnosed with esophageal candidiasis. Which antifungal agent will the provider prescribe this patient?

Accepted Answer

Fluconazole is commonly used for the treatment of esophageal candidiasis and is generally safe in patients with renal impairment, as its dosage can be adjusted. Other options like Amphotericin B, Itraconazole, and Voriconazole have more significant side effects and may not be as safe in patients with renal impairment or congestive heart failure.

Question 11

A patient who is taking nelfinavir reports moderate to severe diarrhea. What action will the provider recommend?

Accepted Answer

Over-the-counter antidiarrheal drugs can be used to manage diarrhea associated with nelfinavir, as it is a known side effect. Discontinuation or dose reduction is not typically recommended without consulting a healthcare provider, and taking it with food may not alleviate diarrhea.

Question 12

A patient diagnosed with hepatitis B begins treatment with adefovir and asks how long the drug therapy will last. What time frame will the prescriber give the patient?

Accepted Answer

Adefovir is used in the treatment of hepatitis B, a viral infection that can lead to chronic liver disease. Treatment duration with adefovir is often prolonged and indefinite because hepatitis B is a chronic condition that may not be completely eradicated. The goal is to control the virus and prevent liver damage, rather than a fixed treatment duration.

Question 13

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. Which medication will the provider prescribe?

Accepted Answer

Acyclovir is an antiviral medication used to treat herpes simplex virus infections, which can cause vesicles on the genitals, matching the symptoms described. Azithromycin, Metronidazole, and Tinidazole are used to treat bacterial infections and would not be effective against a viral infection like herpes.

Question 14

What medication will the provider prescribe for a patient with an Enterococcus faecium associated infection who has proven to be ampicillin resistant? (Select all that apply.)

Accepted Answer

Linezolid and Tigecycline are effective against Enterococcus faecium, especially strains that are resistant to ampicillin. Vancomycin is often ineffective against E. faecium due to resistance, and carbapenems are not typically used for this type of infection.

Question 15

The nurse is caring for a patient who is taking a protease inhibitor (PI). Upon review of the laboratory test results, the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. Upon being notified of the test results, what action will the provider take?

Accepted Answer

Protease inhibitors can cause elevated plasma triglycerides and cholesterol as a side effect. The initial approach to managing these elevations often involves non-pharmacological interventions such as diet modification and exercise to help lower lipid levels before considering medication adjustments or additions.

Question 16

A patient who is taking didanosine reports nausea, vomiting, and abdominal pain. What will the provider recommend to this patient?

Accepted Answer

Didanosine can cause pancreatitis, a serious and potentially life-threatening condition, which is indicated by symptoms such as nausea, vomiting, and abdominal pain. Therefore, laboratory tests are necessary to determine the severity of these symptoms and if they are indicative of pancreatitis or another serious adverse effect. Taking the drug with food, stopping and resuming the drug, or taking it in the evening are not appropriate recommendations without first assessing the seriousness of the symptoms through laboratory tests.

Question 17

A patient is taking oral ketoconazole for a systemic fungal infection. The medication administration record notes that the patient is also taking omeprazole for reflux disease. What instructions will the provider give the patient to maximize medication effectiveness?

Accepted Answer

Ketoconazole requires an acidic environment for optimal absorption. Omeprazole, a proton pump inhibitor, reduces stomach acid. Taking omeprazole at least 2 hours after ketoconazole allows for adequate absorption of ketoconazole by ensuring the stomach's acidity is not prematurely reduced.

Question 18

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The provider will order which treatment regimen?

Accepted Answer

The recommended treatment for gonorrhea, according to the CDC, is a dual therapy consisting of Ceftriaxone 250 mg IM once and Azithromycin 1 g PO once. This regimen covers both gonorrhea and potential co-infection with Chlamydia trachomatis.

Question 19

A patient diagnosed with histoplasmosis is being treated with itraconazole. The provider will teach this patient to report which symptoms?

Accepted Answer

Itraconazole, an antifungal medication, can cause gastrointestinal side effects such as nausea, vomiting, and anorexia. Patients should be advised to report these symptoms as they may indicate a need to adjust the treatment.

Question 20

A patient is HIV positive and the provider is about to prescribe zidovudine. Before the medication therapy is initialed the provider will review which of the patient's latest laboratory values?

Accepted Answer

Before initiating zidovudine, a medication used in the treatment of HIV, it is important to review the patient's Complete Blood Count (CBC). Zidovudine can cause bone marrow suppression, leading to anemia, neutropenia, and other hematologic abnormalities, making the CBC a critical parameter to monitor.

Quiz 18: Therapy of Infectious and Parasitic Diseases

A patient with HIV contracts herpes simplex virus (HSV) , and the prescriber orders acyclovir 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. What action will the provider take?

A provider determines that a patient requires a prescription for a narrow spectrum antibacterial drug to treat a gram-positive cocci-related infection. What option will the provider consider? (Select all that apply.)

A female patient who has hepatitis C is being treated with pegylated interferon $\alpha$ and ribavirin. It will be important for the provider to discuss what topic with the patient?

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The provider will order which drug?

A patient is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies, including didanosine. Which laboratory findings would most concern the provider?

A patient starting therapy with efavirenz asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the prescriber provide?

A patient is diagnosed with pelvic inflammatory disease (PID) . Which treatment regimen is most appropriate for reducing the risk of sterility in this patient?

A patient with a history of congestive heart failure and renal impairment is diagnosed with esophageal candidiasis. Which antifungal agent will the provider prescribe this patient?

A patient who is taking nelfinavir reports moderate to severe diarrhea. What action will the provider recommend?

A patient diagnosed with hepatitis B begins treatment with adefovir and asks how long the drug therapy will last. What time frame will the prescriber give the patient?

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. Which medication will the provider prescribe?

What medication will the provider prescribe for a patient with an Enterococcus faecium associated infection who has proven to be ampicillin resistant? (Select all that apply.)

The nurse is caring for a patient who is taking a protease inhibitor (PI) . Upon review of the laboratory test results, the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. Upon being notified of the test results, what action will the provider take?

A patient who is taking didanosine reports nausea, vomiting, and abdominal pain. What will the provider recommend to this patient?

A patient is taking oral ketoconazole for a systemic fungal infection. The medication administration record notes that the patient is also taking omeprazole for reflux disease. What instructions will the provider give the patient to maximize medication effectiveness?

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The provider will order which treatment regimen?

A patient diagnosed with histoplasmosis is being treated with itraconazole. The provider will teach this patient to report which symptoms?

A patient is HIV positive and the provider is about to prescribe zidovudine. Before the medication therapy is initialed the provider will review which of the patient's latest laboratory values?

Quiz 18: Therapy of Infectious and Parasitic Diseases

A patient with HIV contracts herpes simplex virus (HSV) , and the prescriber orders acyclovir 400 mg PO twice daily for 10 days. After 7 days of therapy, the patient reports having an increased number of lesions. What action will the provider take?

A provider determines that a patient requires a prescription for a narrow spectrum antibacterial drug to treat a gram-positive cocci-related infection. What option will the provider consider? (Select all that apply.)

A female patient who has hepatitis C is being treated with pegylated interferon α\alphaα and ribavirin. It will be important for the provider to discuss what topic with the patient?

During a routine screening, an asymptomatic, pregnant patient at 37 weeks' gestation learns that she has an infection caused by Chlamydia trachomatis. The provider will order which drug?

A patient is HIV positive and has a previous history of drug and alcohol abuse. The patient is being treated with combination therapies, including didanosine. Which laboratory findings would most concern the provider?

A patient starting therapy with efavirenz asks about the timing of the medication with regard to meals. What patient education about the administration of this medication should the prescriber provide?

A patient is diagnosed with pelvic inflammatory disease (PID) . Which treatment regimen is most appropriate for reducing the risk of sterility in this patient?

A patient with a history of congestive heart failure and renal impairment is diagnosed with esophageal candidiasis. Which antifungal agent will the provider prescribe this patient?

A patient who is taking nelfinavir reports moderate to severe diarrhea. What action will the provider recommend?

A patient diagnosed with hepatitis B begins treatment with adefovir and asks how long the drug therapy will last. What time frame will the prescriber give the patient?

A patient complains of painful urination. A physical examination reveals vesicles on her labia, vagina, and the foreskin of her clitoris. Which medication will the provider prescribe?

What medication will the provider prescribe for a patient with an Enterococcus faecium associated infection who has proven to be ampicillin resistant? (Select all that apply.)

The nurse is caring for a patient who is taking a protease inhibitor (PI) . Upon review of the laboratory test results, the nurse notes that the patient has newly elevated plasma triglycerides and cholesterol. Upon being notified of the test results, what action will the provider take?

A patient who is taking didanosine reports nausea, vomiting, and abdominal pain. What will the provider recommend to this patient?

A patient is taking oral ketoconazole for a systemic fungal infection. The medication administration record notes that the patient is also taking omeprazole for reflux disease. What instructions will the provider give the patient to maximize medication effectiveness?

An adolescent patient with mild cervicitis is diagnosed with gonorrhea. The provider will order which treatment regimen?

A patient diagnosed with histoplasmosis is being treated with itraconazole. The provider will teach this patient to report which symptoms?

A patient is HIV positive and the provider is about to prescribe zidovudine. Before the medication therapy is initialed the provider will review which of the patient's latest laboratory values?

A female patient who has hepatitis C is being treated with pegylated interferon $\alpha$ and ribavirin. It will be important for the provider to discuss what topic with the patient?